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dc.contributor.authorBatista, Hermes Melo Teixeira
dc.contributor.authorde Menezes Silveira, Gylmara Bezerra
dc.contributor.authorCampos, Marcelo Ferraz
dc.contributor.authorCarlesso, Juliana Spat
dc.contributor.authorValenti, Vítor Engracia [UNESP]
dc.contributor.authorRaimundo, Rodrigo Daminello
dc.contributor.authorRiera, Andrés Ricardo Pérez
dc.identifier.citationJournal of Human Growth and Development, v. 29, n. 2, p. 284-294, 2019.
dc.description.abstractIntroduction: All drugs and techniques that induce the anesthetic state act in some way in the Autonomic Nervous System (ANS). The administration of local anesthetics in the subarachnoid space produces motor, sensitive and sympathetic block, with latencies and variable and independent block levels. The motor block is the first to install, followed by the sympathetic and the sensitive. Sympathetic blockage affects 2 to 6 dermatomes above the sensory block. The recovery of spinal anesthesia is assessed through a scale defined in 1979 by Bromage and is based exclusively on the return of motor function and does not take into account the recovery of ANS activity. The persistence of sympathetic block may imply a higher incidence of urinary retention, bradycardia and hypotension. Objective: To assess cardiac autonomic modulation during perioperative hypotension caused by subarachnoid anesthesia Methods: A randomised, double-blind clinical trial will be performed in a large hospital located in the southern region of Ceara, Brazil and at the HUJB in Cajazeiras, Paraiba. Sixty patients from the anaesthesia outpatient clinic were enrolled. Patients were divided into two groups: one group received Bupivacaine with clonidine, and the other group received only bupivacaine at a dose of 15 mg. The sample consisted of 60 ASA patients I to III, submitted to orthopedic surgery of lower limbs and lower abdomen under spinal anesthesia. The Heart Rate Variability will be evaluated in three moments: rest, before anesthesia; 20 min after the blockade was installed, and at the time of motor function recovery according to the Bromage criteria and prognostic indices will be evaluated in the development of perioperative hypotension in two groups. Linear methods will be used in the frequency domain and nonlinear in chaos domain, Poincare plot, approximate entropy, Detrended Fluctuation Analysis (DFA) and Correlation Dimension. The data will be collected through a Polar V800® heart rate meter and properly submitted for analysis and filtering by Kubios 3.0® software. Discussion: In the literature we find data evaluating the installation of sympathetic block through HRV using linear methods however, there is a lack of studies using methods based on the domain of chaos. Some studies address the value of HRV as a predictor of hypotension following subarachnoid anesthesia, mainly using linear methods in the frequency domain. It is understood to be important to analyze these factors using methods already validated in the domain of chaos, complexity and fractality, more compatible with the complexity of the behavior of biological systems, in the characterization of the autonomic function during the subarachnoid anesthesia. Registry: The clinical trial was registered in the Brazilian Registry of Clinical Trials (ReBEC) under the number RBR-4Q53D6. © The authors (2019)..en
dc.relation.ispartofJournal of Human Growth and Development
dc.subjectAutonomic nervous system
dc.subjectHeart rate
dc.subjectRecovery room post anesthetic
dc.subjectSpinal anesthesia
dc.subjectSympathic block
dc.titleFractality and chaotic behavior of heart rate variability as hypotension predictors after spinal anesthesia: Study protocol for a randomized controlled trialen
dc.contributor.institutionCentro Universitário Saúde ABC
dc.contributor.institutionHospital Universitário Júlio Bandeira (HUJB)
dc.contributor.institutionFaculdade de Medicina Estácio de Juazeiro do Norte (Estácio FMJ)
dc.contributor.institutionHospital Regional do Cariri (ISGH)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.description.affiliationLaboratório de Delineamento e Escrita Científica Centro Universitário Saúde ABC
dc.description.affiliationDepartmento de Anestesiologia Hospital Universitário Júlio Bandeira (HUJB)
dc.description.affiliationFaculdade de Medicina Estácio de Juazeiro do Norte (Estácio FMJ)
dc.description.affiliationHospital Regional do Cariri (ISGH)
dc.description.affiliationDepartmento de Terapia da Fala e Audiologia Faculdade de Filosofia e Ciências (UNESP)
dc.description.affiliationUnespDepartmento de Terapia da Fala e Audiologia Faculdade de Filosofia e Ciências (UNESP)
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